Legal & General - Mitchells & Butlers Pension Plan Pension Application Form

Please ensure you complete all the required fields or you will not be able to submit the form at the end.

Personal Details

Title

First name(s)

Surname

Date of birth

Su	Mo	Tu	We	Th	Fr	Sa
						1
2	3	4	5	6	7	8
9	10	11	12	13	14	15
16	17	18	19	20	21	22
23	24	25	26	27	28	29
30	31

National Insurance number

Address line 1

Address line 2

Town

County

Postcode

Telephone number

Mobile number

Email address (preferably a personal work email address so we can communicate with you about your pension savings directly. Alternatively you can provide your own personal email address)

Your contributions

Your contribution

Anything above 5% is classed as an AVC and does not attract matching Company contributions. Please refer to Your DC Choice Pension Employee Guide for further information.

Legal and General will issue a Membership Certificate to you within 21 days of receipt of your first contribution to DC Choice. Your first contribution should be made within eight weeks of you submitting this form. If contributions are not deducted within eight weeks, or if you do not receive your Membership Certificate within 21 days of this deduction, please contact L&G on 0345 070 8686.

You will automatically participate in Salary Exchange; this may affect your benefits if you leave the Company within the first 30 days of joining DC Choice. Contact Payroll Control (payroll.control@mbplc.com) to opt-out of Salary Exchange.

Your investment choice

When you join the Plan, your savings will automatically be invested in the default investment option (the Default Target Date Fund).

You can change how your account is invested at any time through Legal & General’s online Manage Your Account service. Before making any changes, it is important you read and understand the DC Choice Investment Guide.

Your selected retirement date

What age do you think you want/would like to access your pension benefits?

Lump sum amount: £

Beneficiary form

In the event of your death, it is the trustees’ duty to decide to whom the death benefits should be paid. Please complete the beneficiary form to nominate your choice of beneficiary(ies) and dependant(s). The trustees are not bound by your wishes, but will always take them into account when making their decisions.

Simply complete the Death Benefit Normination form to nominate your beneficiaries.

Declaration

I confirm I have read the DC Choice Member Booklet.

I apply to the trustees to join DC Choice based on the terms of the Trust Deeds and Rules. I also authorise the Company to deduct my personal contributions from my pay as set out in this application form.

By submitting this form you consent to the trustees using the personal data you provide to them in the administration and operation of DC Choice.

Please complete an 'online signature' by entering your full name in the box below before submitting this form.

I agree with the above declarations.

Full name

Today's date

Mitchells & Butlers Pension Plan